Medical Billing Specialist

Billing Specialist- Florida Cardiovascular Partners

This position is fully in office in the Stuart, FL area.

Job Description

The Billing & Insurance Coordinator is responsible for supporting the practices billing and revenue cycle functions through accurate insurance verification, authorization management, claims processing assistance, and patient billing support. This position plays an essential role in ensuring that patients are financially cleared for their appointments and that claims are processed efficiently and correctly. The individual in this role must demonstrate strong attention to detail, professionalism, and effective communication when working with patients, staff, and insurance carriers.

Objective of This Role

• Ensure all patients are fully financially cleared prior to their scheduled visit through thorough insurance verification and benefit review.
• Support timely and accurate claims processing to minimize errors, reduce denials, and improve reimbursement.
• Provide responsive, courteous assistance to patients regarding billing questions, balances, and insurance concerns.
• Maintain strong coordination between clinical, front office, and billing teams to promote smooth financial workflows.
• Contribute to a compliant, organized, and patient-focused billing environment.

Daily Responsibilities

• Verify insurance eligibility, benefits, and copay requirements for all scheduled patients.
• Complete all insurance verifications before the patient appointment and follow up on missing or incomplete information.
• Obtain prior authorizations and referrals for office visits, diagnostic testing, and procedures when required.
• Review patient benefits to determine copays, coinsurance, and coverage details.
• Work assigned daily claim queues and billing work logs, including denials, edits, and claims needing correction.
• Research and resolve issues preventing claims from being submitted or paid.
• Answer patient billing phone calls for the Vero Beach location, offering clear and professional support.
• Contact patients with outstanding bad debt balances prior to upcoming appointments to review payment expectations.
• Prepare and send Good Faith Estimates (GFEs) to self-pay patients following regulatory guidelines.
• Support general billing functions including insurance verification, benefit review, claims follow-up, and other tasks assigned by leadership.
• Maintain accuracy, confidentiality, and professionalism in all billing-related activities.

Monthly Responsibilities

• Assist with month-end claims review, including unresolved denials and outstanding claims requiring follow-up.
• Review recurring denial patterns or verification issues and escalate trends to leadership.
• Support any scheduled audits or internal reviews related to insurance verification, authorizations, or claim accuracy.
• Participate in billing or revenue cycle meetings when requested.
• Maintain updated referral and authorization logs.
• Confirm that GFEs for self-pay patients were issued, documented, and stored appropriately.

Qualifications

• Experience in medical billing, insurance verification, or healthcare administration preferred.
• Strong knowledge of insurance benefits, authorizations, and billing terminology.
• Knowledge of CPT and ICD 10 codes.
• Knowledge of modifiers.
• Experience in hospital charge posting is preferred.
• Excellent communication and customer service skills.
• High attention to detail and strong organizational abilities.
• Ability to multitask and work efficiently in a clinical environment.